Abstract
Purpose: To determine the pattern of prescription of non-steroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs) co-prescription with NSAIDs in a sample of patients suffering from musculoskeletal disorders with and without co-morbid cardiovascular (CV) disease conditions in Baghdad Province, Iraq.Methods: A descriptive, cross-sectional study was conducted using a structured questionnaire to assess the clinical characteristics of patients that used NSAIDs alone or with PPIs for the treatment of different musculoskeletal disorders with and without co-morbid cardiovascular (CV) disease conditions.Results: A total of 102 participants were enrolled in the study. More than half of the participants had comorbid disease conditions (53.9 %), particularly hypertension (47.1 %). Nearly a quarter of the participants with CV disease conditions used non-selective NSAIDs (25.5 %). The majority of NSAIDs intake were orally administered for more than one month (79.4 %). Physicians were the major source for patient education about the risk of NSAIDs-associated complications according to 59.6 % of the participants. The majority of participants reported non-adherence to the prescribed PPIs (86.5 %). There was a statistically significant difference between the participants that used NSAIDs alone, and those with PPI co-prescription within the age group of 31 - 60 years (p < 0.0001) and for a duration of more than one month for NSAIDs administration (p < 0.0001).Conclusion: There is improper use of NSAIDs, particularly the non-selective agents, among patients with co-morbid cardiovascular disease conditions, as well as poor medication adherence and improper co-prescription of PPIs. This requires periodic revision for long-term intake of NSAIDs, while applying more care to high-risk patients regarding co-prescription of NSAIDs with PPIs.
 Keywords: Cardiovascular, Co-morbidity, Gastrointestinal complications, NSAIDs, Proton-pump inhibitors
Highlights
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are the most common anti-inflammatory and analgesic agents used for the treatment of a wide range of musculoskeletal disease conditions [1]
The inhibition of COX-1 isoform enzyme is associated with the incidence of NSAIDs side effects, whereas inhibition of COX2 isoform enzyme is associated with their pharmacological effects, including analgesic and anti-inflammatory effects [2]
The findings of this study showed that 25.5 % of the participants with CV conditions used non-selective NSAIDs, aside from low-dose aspirin
Summary
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are the most common anti-inflammatory and analgesic agents used for the treatment of a wide range of musculoskeletal disease conditions [1]. They act through inhibition of COX-1 and COX-2 enzymes. Extensive use of NSAIDs in prescriptions or short-term, low doses of overthe-counter administration has been frequently associated with many gastrointestinal tract (GIT) complications, such as dyspepsia, gut inflammation, mucosal erosions, gastric and duodenal ulcers and bleeding [3]. Besides GIT adverse effects, the use of NSAIDs is associated with a range of serious complications, including cardiovascular (CV) events, renal failure and hypersensitivity reactions [4,5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
